Quadriceps strengthening, quadriceps stretching and patellar taping are commonly prescribed for most subgroups of patellofemoral pain. This study aimed to examine the effectiveness of each of these techniques in isolation and in combination over a one-week period. A blind, controlled, randomised study was designed involving 46 patients with 60 knees diagnosed with patellofemoral pain. The knees were randomized into one of 4 groups (n = 15): Quadriceps (specifically vastus medialis) strengthening; quadriceps stretching; infra-patellar taping and control. The strengthening group followed an intensive program of non-weight-bearing quadriceps exercises, the stretching group followed a program of rectus femoris stretching. The infrapatellar taping was worn continually for the week. The control group received advice but no treatment. Pre and post-treatment measures included isokinetic quadriceps strength, quadriceps length measured in prone, pain measured during four activities, and maximum eccentric knee flexion angle during a step down. Results showed significant changes over time (p < 0.01) in six of seven activities for the stretching group, in five of seven in the strengthening group, in two of seven for the taping group and in none of the activities for the control group. When the three treatment methods were combined for one week (n = 60) all seven measures improved significantly (p < 0.005). In isolation, quadriceps stretching resulted in improvements in more measures than other treatments. Combining these three generic treatments is recommended as the initial approach to treating patellofemoral pain but further specific/ individualized treatment for subgroups is essential.
Australian Physiotherapy Association (APA) Conference Week : Musculoskeletal Physiotherapy Australia, Sydney, Australia 1-5 October 2009
Australian Journal of Physiotherapy: e-Supplement 2009 APA Conference Week Abstracts / Vol. 55, No. 4, p.23